Kaiser Permanente Northern California is rolling out innovative new technology for psychologists and addiction specialists to assess and track patient progress and to alert therapists about issues requiring immediate attention.

The new system includes an iPad patient survey to report such issues as depression, anxiety, harm to others, suicide risk, post-traumatic stress disorder, and alcohol and drug use.

The accompanying software, called Tridiuum, scores patients’ progress over time, giving therapists a transformative new tool to aid them in treatment decisions, said Ken Shigematsu, director for outcomes and clinical innovation projects at Kaiser Permanente Northern California. This type of evidence-based treatment that includes a detailed view of patient progress has not traditionally been used in psychological therapy, he added.

“When you go into your doctor’s office to get a blood pressure check, the doctor is using the numbers to treat it, and the goal is to get the number down,” said Shigematsu, who was previously a director in the Kaiser Permanente San Francisco Psychiatry Department for 22 years. “We as psychologists never had that. And now we have something.”

The new technology goes hand-in-hand with Kaiser Permanente’s feedback informed care approach to mental health in which a therapist and patient monitor treatment together to assess how well it is working.

Thousands of iPads

By the end of this year, 1,150 iPads will be in the hands of therapists throughout Kaiser Permanente Northern California. They already are in place in Walnut Creek, Redwood City, San Mateo, and San Rafael, Shigematsu said. A rollout in Southern California is complete, Georgia is deploying now, and plans are to place it in all Kaiser Permanente locations nationwide.

“The thing I really like about it is I can show patients how far they have come,” said Bonnie Doughty, a therapist using the new system in the Walnut Creek Addiction Medicine Recovery Services who has been working in addiction medicine at Kaiser Permanente for 11 years. “We’ve had experience using other feedback informed care metrics, but this is by far the broadest scope and really the best experience for patients and clinicians we’ve seen.”

Shigematsu said during a first appointment, patients are often more honest about what is bothering them when they fill out an online survey rather than answering questions posed by a therapist they just met. The electronic survey also helps therapists get more immediate insight into what’s going on in a person’s life.

“As the patient is filling it out, the clinician can be in his or her office and see what areas are good and what areas need additional or immediate support,” Shigematsu said. “So when the clinician comes into the waiting room to get the member, we can see immediately if they are having risks in certain areas. And the clinician will be able to get this information every time the patient comes in.”

Tool Supports Treatment Decisions

The software can help a therapist decide what kind of treatment to use, what outcomes are important to the patient, and when to consider concluding treatment, Shigematsu said.

“In the past, we used a paper assessment form, but instead of tracking the responses over time, we just asked, ‘How are you doing today?” Shigematsu said. “But that was not always reliable. By tracking patient scores, if we see their numbers come back to a normal, acceptable level, we can eventually ask ‘Are you ready to phase out treatment?’”

Shigematsu emphasized this relatively new way of treating mental health will now be more closely in line with how physicians treat physical diseases.

“If you think about the Kaiser Permanente hospitals, they want to know if you have your diabetes under control, your blood pressure is under control, and you’ve had your mammography, for example,” Shigematsu said. “This is similar in that we now have a tool for the therapist to tell how the patient is doing over time and what the next steps are.”